Individual
CRISTIN C SLATER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
111 MAIN ST, #100, BOISE, ID 83702-7307
(208) 342-5900
(208) 342-2088
Mailing address
111 MAIN ST, #100, BOISE, ID 83702-7307
(208) 342-5900
(208) 342-2088
Taxonomy
Speciality
Code
Description
License number
State
207VE0102X
Reproductive Endocrinology Physician
61941811205
UT
207VE0102X
Reproductive Endocrinology Physician
G81581
CA
207VE0102X
Reproductive Endocrinology Physician
Primary
M8614
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51292
BLUE CROSS
ID
Enumeration date
09/16/2006
Last updated
07/08/2007
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